{include file="top.tpl"}
{include file="header.tpl"}

<script type="text/javascript" src="{$WPATH}js/contact.js"></script>

<div class="mainbody wrapper">  
	<div class="viewpage">
       		<div class="contact_info left">
                <div class="">
                        {$PAGECONTENT->cat_description}
                </div>
            	

            </div>	  	
        	<div class="fr_formcontact left">
            	 <div class="txt_require">
                    Please fill in all information and send to us.
                </div>
             	<form name="frmContact" id="frmContact" method="post"  action="" onSubmit="return onSendContactEmail('frmContact', 'ajaxResponse','{$WPATH}lien-he/','{$WPATH}lien-he/'); ">
                    <input type="hidden" name="act" value="sendcontactemail" />
                    <table cellpadding="0" cellspacing="0">
                    	<tr>
                        	<th></th>
                            <td><div id="ajaxResponse" class="message"></div></td>
                        </tr>
                    	<tr>
                        	<th><span>*</span>{ntp_tr}Full name{/ntp_tr}:</th>
                            <td><input name="name" type="text" size="29" /></td>
                        </tr>
                        <tr>
                        	<th><span>*</span>{ntp_tr}Address{/ntp_tr}:</th>
                            <td><input name="address" type="text" size="29" /></td>
                        </tr>
                        <tr>
                        	<th><span>*</span>{ntp_tr}Telephone number{/ntp_tr}:</th>
                            <td><input name="phone" type="text" size="29" /></td>
                        </tr>
                        <tr>
                        	<th><span>*</span>E-mail:</th>
                            <td><input name="email" type="text" size="29" /></td>
                        </tr>
                        <tr>
                        	<th style="vertical-align:top"><span>*</span>{ntp_tr}Information{/ntp_tr}:</th>
                            <td><textarea name="information" cols="22" rows="5" class="left"></textarea></td>
                        </tr>
                        <tr>
                        	<th style="vertical-align:top" colspan="2">{ntp_tr}Please enter the indentification code here.{/ntp_tr}</th>
                        </tr>
                        <tr>
                                <th style="vertical-align:top"><span>*</span>{ntp_tr}Identification code{/ntp_tr}:</th>
                                <td><input name="code" type="text" size="29" /></td>
                            </tr>
                        <tr>
                                <th style="vertical-align:top"></th>
                                <td>
                                    <img src="{$WPATH}captcha.php" alt="Captcha Image" style="border:1px solid #545353;" id="captchaImg" /><br />
                <a href="#" onclick="time = new Date(); document.getElementById('captchaImg').src = '{$WPATH}captcha.php?' + time.getTime(); return false;">{ntp_tr}Refesh code{/ntp_tr}</a>
                                </td>
                            </tr>

                        <tr>
                        	<th style="vertical-align:top" colspan="2">
                            <font color="#FF0000">{ntp_tr}You have to fill out all fields maked with{/ntp_tr} (*)</font>
                            </th>
                        </tr>
                        <tr>
                        	<th style="vertical-align:top"></th>
                            <td valign="top"><input type="submit" class="btn_send point" value="{ntp_tr}send{/ntp_tr}"/></td>
                        </tr>
                    </table>
                </form>        
            </div>
            
 	</div>
    <div class="clear" /></div>
</div>
{include file="footer.tpl"}        